Provider Demographics
NPI:1265602528
Name:ADVANTAGE CONDUCTION AND PHYSICAL THERAPY
Entity type:Organization
Organization Name:ADVANTAGE CONDUCTION AND PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSCIAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:
Authorized Official - Last Name:SPADAFORA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:609-235-9596
Mailing Address - Street 1:55 SPRUCE MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NJ
Mailing Address - Zip Code:08831-3101
Mailing Address - Country:US
Mailing Address - Phone:609-235-9596
Mailing Address - Fax:
Practice Address - Street 1:55 SPRUCE MEADOWS DR
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NJ
Practice Address - Zip Code:08831-3101
Practice Address - Country:US
Practice Address - Phone:609-235-9596
Practice Address - Fax:609-235-9565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-03
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty